Topic Contents

Discusses common injuries such as a chipped or broken tooth, mouth pain, or a puncture or tear in your lip, tongue, or inside your mouth. Offers home treatment and prevention tips. Includes interactive tool to help you decide when to call a doctor.

Mouth and Dental Injuries

Topic Overview

Mouth
injuries are common, especially in children, and may involve the teeth, jaw,
lips, tongue, inner cheeks, gums, roof of the mouth (hard or soft palates),
neck, or
tonsils. Sometimes mouth injuries look worse than they
are. Even a small cut or puncture inside the mouth may bleed a lot because
there are many blood vessels in the head and neck area. Home treatment of minor
mouth injuries can help stop bleeding, reduce pain, help healing, and prevent
infection.

Teeth may be injured during a fall or a sport
activity. A tooth may be knocked out (avulsed). You may be able to replace a
permanent tooth in its socket (reimplant) if it has been knocked out or torn
away from the socket. Immediate
first aid and dental care are needed when a permanent
tooth has been knocked out.

An injury could
crack ,
chip, or break a tooth, or make a tooth
change color . A tooth also may be
loose or moved in position (dental luxation) or
jammed into the gum (intruded).

Other
dental injuries may be caused by
grinding your teeth , especially at night. Your teeth
may hurt, chip, or become loose. Biting surfaces may become flat and worn down.
A
broken or loose dental appliance or an orthodontic
wire or bracket may poke or rub the inside of your mouth and make your mouth
sore.

An injury to your mouth or lips may cause a large, loose flap
of tissue or a gaping wound that may
need stitches. A smaller wound on the lip may be
stitched for cosmetic reasons. If an object, such as a piece of broken tooth or
an orthodontic wire, gets stuck in a wound, you may need to have it removed by
a doctor. You can also have problems from a
piercing in the mouth.

The piece of skin between your lips and gums
or under your tongue (
frenulum) may tear or rip. Usually this type of injury
will heal without stitches. It is generally not a concern unless the tear was
caused by physical or sexual
abuse .

An injury to the roof of your
mouth, the back of your throat, or a tonsil can injure deeper tissues in your
head or neck. These injuries can happen when a child falls with a pointed
object, such as a pencil or Popsicle stick, in his or her mouth.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Pain in adults and older children

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.

Long-term alcohol and drug
problems.

Steroid medicines, which may be used to treat a variety
of conditions.

Chemotherapy and radiation therapy for
cancer.

Other medicines used to treat autoimmune
disease.

Medicines taken after organ transplant.

Not
having a spleen.

Symptoms of infection may
include:

Increased pain, swelling, warmth, or redness in or
around the area.

Red streaks leading from the area.

Pus draining from the area.

A fever.

With severe bleeding, any of these may
be true:

Blood is pumping from the wound.

The
bleeding does not stop or slow down with pressure.

Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may
be true:

The bleeding slows or stops with pressure but
starts again if you remove the pressure.

The blood may soak through
a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be
true:

The bleeding stops on its own or with
pressure.

The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are:

You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot.

For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:

You haven't had a tetanus shot in the past 5
years.

You don't know when your last shot was.

For a clean wound, you may
need a shot if:

You have not had a tetanus shot in the past 10
years.

You don't know when your last shot was.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.

Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

If you can get to a dentist's office (or an emergency room)
within an hour or two of the injury, the dentist may be able to reimplant the
tooth in its socket.

To preserve the tooth until you get to the dentist:

Pick up the tooth at its top, not at the
root.

Rinse the tooth with water. Do not rub or scrub
it.

Put the tooth back in the socket. Bite down gently on gauze or
a clean cloth to keep the tooth in place, or hold the tooth in place with your
finger. (This is not a good idea for anyone who might swallow the
tooth.)

Another option is to put the tooth in a small container of
milk. Use tap water if you don't have milk.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

Make an appointment to see your doctor in the
next 1 to 2 weeks.

If appropriate, try home treatment while you
are waiting for the appointment.

If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your dentist now to discuss the symptoms and
arrange for care.

If you cannot reach your dentist or you don't
have one, seek care in the next hour.

Home Treatment

First aid steps

If you need to see a doctor for your injury, call to arrange for your care and ask what steps to take in the meantime.

A tooth that has been completely knocked out . A permanent tooth can sometimes be put back into its socket
(reimplanted). The best results occur if a dentist puts the tooth back in the
socket within 30 minutes. Chances of successful reimplantation are unlikely
after 2 hours.

Bleeding in the mouth . Return any skin
flap to its normal position. If necessary, hold the flap in place with a clean
cloth or gauze.

A broken tooth or dental appliance . Find any pieces of tooth or the broken dental
appliance and take them with you when you go to see your dentist. Your dentist
will want to check for missing pieces of tooth or dental appliance that may
have been left in a wound, swallowed, or inhaled into the lungs
(aspirated).

To reduce pain and promote healing

Apply a
cold compress to the injured area, or suck on a piece of ice or a flavored ice pop, such as a Popsicle, as
often as desired.

Rinse your wound with warm salt water immediately
after meals. Saltwater rinses may promote healing. To make a saltwater solution
for rinsing the mouth, mix
1 tsp (5 g) of salt to
1 cup (250 mL) of warm
water.

Meat and
meat substitutes, such as tender meats or chicken, tuna, eggs, and smooth peanut
butter.

Fruits and vegetables, such as well-cooked or canned fruits
and vegetables; well-ripened, easy-to-chew fruits; and baked, mashed, or
well-cooked sweet potatoes.

Avoid foods that might sting, such as salty or
spicy foods, citrus fruits or juices, and tomatoes.

Do not smoke or
use other tobacco products. For more information, see the topic
Quitting Smoking .

Do not drink
alcohol.

If a jagged tooth or orthodontic wire or bracket is poking
you, roll a piece of melted candle wax or orthodontic wax and press it onto the
part that is poking you. Use a pencil eraser to press a broken wire toward your
teeth. These are only temporary measures to use until you can see your dentist
or orthodontist to fix the problem.

Try a topical medicine, such
as Orabase or Ulcerease, to reduce mouth pain.

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these
safety tips when you use a nonprescription medicine:

Carefully read and follow all directions
on the medicine bottle and box.

Symptoms to watch for during home treatment

Prevention

Many mouth and dental injuries can be
prevented by taking the following steps.

Have regular dental checkups. If your gums and
teeth are healthy, you are more likely to recover from an injury quickly and
completely. For more information, see the topic
Basic Dental
Care .

Use a seat belt to prevent or reduce injuries to the mouth
during a motor vehicle accident. Always place your child in a
child car seat to prevent injuries.

Wear a
mouth guard while participating in sports. A mouth
protector can be made by a dentist or purchased at a store that sells athletic
supplies.

Wear a helmet and face guard in sports during which a
face, mouth, or head injury could occur.

If you wear an
orthodontic appliance, such as a retainer or headgear, follow your
orthodontist's instructions about proper wear and care of it. Learn as much
about your orthodontic appliance as you can.

Remove headgear and wear a protective mouth
guard when playing sports.

Remove headgear before engaging in rough
play.

Do not eat foods that are hard, chewy, crunchy, or
sticky.

Do not pick at or pull on your braces.

Use
orthodontic wax to protect the inside of your mouth from poking
wires.

Store the appliance in the case provided by your
orthodontist.

If you
grind your teeth , ask your dentist whether he or she
recommends a mouth guard.

If you have
seizures or other medical problems that may increase
your risk of falls, ask your doctor if and when he or she
recommends that you use a helmet and face guard to protect your head and mouth.

More steps to prevent mouth and dental injuries in
young children include the following:

Be aware of your child's chance of falling, and take steps to
prevent falls .

When your toddler is using a bottle or sippy cup, have him or her stay seated. Don't allow your child to walk or run with any objects in his or her mouth.

Never leave a baby unattended in high places, such as on a tabletop, in a crib with the sides down, or even on a bed or sofa.

Do not leave a baby unattended in any infant seat or "sitting" toy, such as a swing, walker, saucer, or jumper. Use all the safety straps provided.

Be gentle when placing a bottle or
spoon in a baby's or child's mouth. An object that is jammed into the mouth can
tear the skin between the lips and gums or under the tongue
(frenulum).

If your child has protruding teeth, have them examined
by a dentist. Protruding teeth are more likely to be injured.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the
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